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Ogle LN, Garman-McClaine BA, Ruble LA. Intervention Plan Quality Matters: Using COMPASS to Collaboratively Develop Student-Centered, Evidence-based Intervention Plans using an EBPP Approach. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2024; 34:265-289. [PMID: 39072267 PMCID: PMC11280249 DOI: 10.1080/10474412.2024.2352464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/03/2024] [Indexed: 07/30/2024]
Abstract
The quality of interventions for children with autism has improved thanks in part to the widespread dissemination of evidence-based practices (EBPs); however, teachers still report challenges developing focused interventions targeting the core challenges of students with autism. Tested in three randomized trials, COMPASS is a consultation-based implementation strategy that prioritizes shared decision-making in the development of goals and intervention plans using an evidence-based practice in psychology approach. To successfully train COMPASS consultants, a 16-item Intervention Plan Quality Scale (IPQS) was developed and tested with a set of nine school-based COMPASS-trained consultants who provided a total of 28 consultations. Results revealed that the IPQS had acceptable reliability and concurrent validity and was successful in helping consultant trainees develop high-quality plans over four feedback sessions. Overall, the IPQS was helpful for fidelity monitoring and appears to partially mediate child goal attainment outcomes through teacher adherence implementing the intervention plans.
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Affiliation(s)
| | | | - Lisa A Ruble
- Ball State University, Department of Special Education
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2
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Kranak MP, Brown KR. Updated Recommendations for Reinforcement Schedule Thinning following Functional Communication Training. Behav Anal Pract 2024; 17:87-106. [PMID: 38405284 PMCID: PMC10891008 DOI: 10.1007/s40617-023-00863-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 02/27/2024] Open
Abstract
Schedule thinning is a necessary treatment procedure following the acquisition of a communication response during functional communication training. In this article, we update and extend the Hagopian et al. Behavior Analysis in Practice, 4, 4-16, (2011) review and recommendations on schedule-thinning procedures following functional communication training. Since their publication, substantial research has been published on the efficacy, efficiency, and social validity of schedule-thinning methods. We provide updated recommendations for schedule thinning based on contemporary literature that has been published since 2011, as well as discuss key areas for future research.
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Affiliation(s)
- Michael P. Kranak
- Oakland University, Rochester, MI USA
- Oakland University Center for Autism, Rochester, MI USA
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3
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Muharib R, Walker V, Dunn W. Effects of Interventions Involving Tablet-Based Speech-Generating Devices for Individuals with ASD: A Meta-analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06173-6. [PMID: 38019361 DOI: 10.1007/s10803-023-06173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/30/2023]
Abstract
The purpose of this review was to assess the effectiveness of tablet-based speech-generating devices (SGDs) in improving communication skills for individuals with autism spectrum disorder (ASD). A total of 31 single-case design intervention studies involving 84 individuals with ASD were reviewed and included in the analysis. We calculated Tau-U to evaluate the impact of interventions involving tablet-based SGDs on four different communication responses: specifically, mands, intraverbals, tacts, and vocalizations. To explore potential moderating variables for mand outcomes, we used the Kruskal-Wallis one-way test. The analysis revealed that interventions utilizing tablet-based SGDs led to improvements in communication responses. Specifically, large to very large changes were observed in mand and intraverbal responses, whereas moderate changes were noted in tact responses and vocalizations. The findings of this review underscore the potential of tablet-based SGDs in enhancing communication among individuals with ASD. We discuss the findings and provide implications for future research and practice.
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Affiliation(s)
| | - Virginia Walker
- University of North Carolina at Charlotte, Charlotte, NC, USA
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Goodall M, Irving K, Nevin M. The recognition, assessment and perceptions of total pain in people with profound intellectual disabilities: A mixed methods systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:940-950. [PMID: 37365750 DOI: 10.1111/jar.13132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND People with profound intellectual disabilities are a population with complex comorbidities. Total pain recognises the interconnectedness of aspects of pain; social, psychological, physical, emotional, spiritual. Pain is under-recognised due to communication challenges and carers perceptions. This review's purpose is to synthesise current literature and provide guidance for future research and care. METHODS Five databases were searched in this mixed methods systematic review (Cinahl, Medline, Psycinfo, Web of Science, Scopus). Articles retrieved were reported via a PRISMA flow diagram. Quality appraisal utilised the mixed methods appraisal tool (MMAT). A convergent qualitative design was the method of data synthesis. RESULTS Data from 16 included articles generated four themes; Absent voices, reductionist assessment, pain intensity, valuing expertise. Data included physical pain only. CONCLUSION Multifaceted pain needs inclusion in research. Assessment must consider the unique expressions of pain by individuals with profound intellectual disabilities. A sharing of expertise may improve pain care.
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Affiliation(s)
- Maeve Goodall
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| | - Mary Nevin
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
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Lambert JM, Copeland BA, Paranczak JL, Macdonald MJ, Torelli JN, Houchins-Juarez NJ. Description and evaluation of a function-informed and mechanisms-based framework for treating challenging behavior. J Appl Behav Anal 2022; 55:1193-1219. [PMID: 35762194 DOI: 10.1002/jaba.940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 05/31/2022] [Indexed: 11/10/2022]
Abstract
Individualization and iterative design are essential components of the assessment and treatment of challenging behavior. Currently, there are few validated frameworks for engaging in iterative processes. Due to the nature of single-case design, empirically rigorous evaluations of decision-tree processes are particularly prohibitive. Notwithstanding, evaluations are needed. In this paper we first describe a function-informed and mechanisms-based (FIMB) framework for selecting treatment components employed by a university-based practicum experience designed to expose pre-service practitioners to a valid treatment process for challenging behavior. Then, we share a completed retrospective consecutive case series across a 6-year period in which we conducted a technique analysis to identify which procedures were most commonly selected in the practicum, and the impact of those choices on client outcomes. The results suggest that the model can be highly effective for some, but not all, cases. Implications are discussed.
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Totsika V, Liew A, Absoud M, Adnams C, Emerson E. Mental health problems in children with intellectual disability. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:432-444. [PMID: 35421380 DOI: 10.1016/s2352-4642(22)00067-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 12/16/2022]
Abstract
Intellectual disability ranks in the top ten causes of disease burden globally and is the top cause in children younger than 5 years. 2-3% of children have an intellectual disability, and about 15% of children present with differences consistent with an intellectual disability (ie, global developmental delay and borderline intellectual functioning). In this Review, we discuss the prevalence of mental health problems, interventions to address these, and issues of access to treatment and services. Where possible, we take a global perspective, given most children with intellectual disability live in low-income and middle-income countries. Approximately 40% of children with intellectual disability present with a diagnosable mental disorder, a rate that is at least double that in children without intellectual disability. Most risk factors for poor mental health and barriers to accessing support are not unique to people with intellectual disability. With proportionate universalism as the guiding principle for reducing poor mental health at scale, we discuss four directions for addressing the mental health inequity in intellectual disability.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK; Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia; Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Ashley Liew
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; National & Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK; Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Colleen Adnams
- Division of Intellectual Disability, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK; Centre for Disability Research & Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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7
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Mitteer DR, Greer BD, Randall KR, Haney SD. On the scope and characteristics of relapse when treating severe destructive behavior. J Appl Behav Anal 2022; 55:688-703. [PMID: 35290666 DOI: 10.1002/jaba.912] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
Prior studies on treatment relapse have typically examined the prevalence of resurgence or renewal of target behavior (e.g., destructive behavior) in isolation. This study analyzed both types of relapse during 25 consecutive treatments involving functional communication training during worsening reinforcement conditions for alternative behavior (i.e., schedule thinning) or following context changes. We also examined disruption of alternative behavior (i.e., functional communication requests, compliance). Resurgence and renewal of destructive behavior occurred in 76% and 69% of treatments, respectively, and in approximately a third of changes in reinforcement or context. Relapse of destructive behavior predicted alternative-response disruption and vice versa; the co-occurrence of these two events always exceeded the background probabilities of either event occurring in isolation. General reductions in treatment efficacy occurred across changes in reinforcement or context, with no apparent decrease in likelihood in later transitions. We discuss implications of our findings with respect to future studies examining treatment durability.
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Affiliation(s)
- Daniel R Mitteer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
| | - Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
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Torelli JN, Pickren SE. Using Chained or Tandem Schedules With Functional Communication Training: A Systematic Review. Behav Modif 2022; 47:185-218. [PMID: 35164521 DOI: 10.1177/01454455221077420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chained and tandem schedules are a common method for thinning schedules of reinforcement following functional communication training (FCT) in the treatment of problem behavior. We conducted a systematic literature review and meta-analysis of chained and tandem schedules following FCT to describe treatment characteristics and evaluate effects. We identified 38 articles and found reductions in problem behavior across four measures. Results of a random-effects multilevel meta-analysis of rigorous evaluations showed a significant effect of chained or tandem schedules + FCT on problem behavior relative to baseline. We observed resurgence in 77% of cases and 31% of schedule-thinning transitions. Results showed chained schedules resulted in greater reductions in problem behavior relative to tandem schedules. Exploratory moderator analyses suggested extinction, combined reinforcement, and delay and denial tolerance training procedures were associated with greater reductions in problem behavior relative to other treatment characteristics. Implications for practice and future research are discussed.
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Muharib R, Dowdy A, Rajaraman A, Jessel J. Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:761-781. [PMID: 34961394 DOI: 10.1177/13623613211065540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.
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Dowdy A, Peltier C, Tincani M, Schneider WJ, Hantula DA, Travers JC. Meta-analyses and effect sizes in applied behavior analysis: A review and discussion. J Appl Behav Anal 2021; 54:1317-1340. [PMID: 34219222 DOI: 10.1002/jaba.862] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/28/2022]
Abstract
For more than four decades, researchers have used meta-analyses to synthesize data from multiple experimental studies often to draw conclusions that are not supported by individual studies. More recently, single-case experimental design (SCED) researchers have adopted meta-analysis techniques to answer research questions with data gleaned from SCED experiments. Meta-analyses enable researchers to answer questions regarding intervention efficacy, generality, and condition boundaries. Here we discuss meta-analysis techniques, the rationale for their adaptation with SCED studies, and current indices used to quantify the effect of SCED data in applied behavior analysis.
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Affiliation(s)
- Art Dowdy
- Department of Teaching and Learning, Temple University
| | - Corey Peltier
- Department of Educational Psychology, University of Oklahoma
| | - Matt Tincani
- Department of Teaching and Learning, Temple University
| | - W Joel Schneider
- Department of Psychological Studies in Education, Temple University
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11
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Lambert JM, Lamers ME, Copeland BA, Banerjee I. Multiple operant discrimination training to increase the precision of stimulus deltas following treatment of challenging behavior. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Joseph M. Lambert
- Department of Special Education Vanderbilt University Nashville Tennessee USA
| | - Mallory E. Lamers
- Department of Special Education Vanderbilt University Nashville Tennessee USA
| | - Bailey A. Copeland
- Department of Special Education Vanderbilt University Nashville Tennessee USA
| | - Ipshita Banerjee
- Department of Special Education Vanderbilt University Nashville Tennessee USA
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12
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Quigley J, Dowdy A, Trucksess K, Finlay A. An Investigation of Functional Communication Training and Schedule Thinning Using a Multiple Schedule on Elopement to Access Stereotypy. J Autism Dev Disord 2020; 51:3224-3234. [PMID: 33196917 DOI: 10.1007/s10803-020-04788-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 10/23/2022]
Abstract
Individuals diagnosed with autism spectrum disorder (ASD) who engage in stereotypy may also emit a prior, temporally contiguous, high-risk response to access stereotypic behaviors. For example, the participant in this study who was diagnosed with ASD engaged in a chained response that included elopement, often in unsafe locations, to access light switch flipping. Previous research indicates that functional communication training (FCT) with delay fading is a viable approach to reduce chained problem behavior. In this study, we extended previous research by (a) evaluating the generalized effect of FCT and schedule thinning using multiple schedule technology for an automatically maintained chained response, and (b) evaluating whether intervention effects maintained in the participant's optimal context. Results for the participant suggested that FCT with schedule thinning mitigated high-risk chained responding across settings and discrimination training using a multiple schedule assessment effectively signaled available and unavailable times for the participant to emit the chained response which matched the participant's natural schedule parameters.
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Affiliation(s)
- Jennifer Quigley
- The Chicago School of Professional Psychology, Chicago, IL, USA.
| | - Art Dowdy
- Temple University, Philadelphia, PA, USA
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